#HPM Tweet Chat 11:9:11

#hpm - Healthcare Social Media Transcript
6/27/12 12:38 PM
#hpm transcript
Healthcare Social Media Transcript
From: To: Wed Nov 09 18:00:00 PST 2011 Wed Nov 09 19:15:00 PST 2011 change time period
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equijada
For the next hour, I will chatting about #hpm. #hpm

Wed Nov 9 18:00:31 PST 2011
renee_berry
@equijada Hi Earl, thanks for hosting tonight! #hpm

Wed Nov 9 18:01:28 PST 2011
aliciabloom
a flurry of #hospice & #palliative care related tweets...it's #hpm tweetchat time-- join us!
Wed Nov 9 18:01:43 PST 2011
jordangrumet
Wifes out of town, kids asleep, ready for tweetchat #hpm

Wed Nov 9 18:01:50 PST 2011
equijada
Hi Renee, Alicia, and Jordan, good to see you #hpm

Wed Nov 9 18:02:28 PST 2011
aliciabloom
@equijada hi earl! great to be here with you & the gang. #hpm
Wed Nov 9 18:03:27 PST 2011
renee_berry
Tweeting by a hospital bed tonight in CA. Reminded many times today how important advance directives are (& doctor communication!) #hpm
Wed Nov 9 18:03:44 PST 2011
http://hashtags.symplur.com/healthcare-hashtag-transcript.php?ha&smin=0&tdate=11-09-2011&thour=19&tmin=15&ssec=00&tsec=00&img=1
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AdvanceCarePlan
end of life care in Oregon: http://t.co/uzwksqF3 #eolc #hpm #eol

Wed Nov 9 18:04:06 PST 2011
authordhallman
Hello fellow hpm tweetchat members. I'm David on-line. Author of palliative care memoir "August Farewell". #hpm
Wed Nov 9 18:04:06 PST 2011
AdvanceCarePlan
RT @renee_berry: Tweeting by a hospital bed tonight in CA. Reminded many times today how important advance directives are (& doctor communication!) #hpm
Wed Nov 9 18:04:20 PST 2011
jordangrumet
Wed Nov 9 18:04:26 PST 2011
joltdude
Sends @renee_berry some coffee or other choice beverage and some virtual flowers #hpm
Wed Nov 9 18:04:28 PST 2011
equijada
@renee_berry off topic: are you going to @rockhealth http://t.co/GVgv6lKT #hpm

Wed Nov 9 18:04:29 PST 2011
equijada
Hi David, welcome. August Farewell - sounds interesting #hpm

Wed Nov 9 18:04:50 PST 2011
aliciabloom
@renee_berry sorry to hear that...sending good thoughts your way. #hpm

Wed Nov 9 18:04:51 PST 2011
equijada
@renee_berry whoa...are you hospitalized? or a friend? or a caregiver? #hpm

Wed Nov 9 18:05:30 PST 2011
uwpride
Wed Nov 9 18:05:52 PST 2011
equijada
topic 1 coming up in a bit. #hpm

Wed Nov 9 18:06:03 PST 2011
equijada
topic 1 coming up in a bit. #hpm

Wed Nov 9 18:06:03 PST 2011
renee_berry
@aliciabloom @equijada thanks, no I'm not in the bed, family member went through the ED & was admitted for a heart issues, doing better #hpm
Wed Nov 9 18:06:37 PST 2011
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IM4PBS
Deb here, caregiver of family members who's #eol experiences included #hpm
Wed Nov 9 18:06:43 PST 2011
equijada
Welcome Deb, thanks for being here. #hpm

Wed Nov 9 18:07:08 PST 2011
renee_berry
@equijada looks awesome, love @rock_health #hpm

Wed Nov 9 18:07:27 PST 2011
jordangrumet
Jordan Grumet here...#hpm friendly Internal Med physician

Wed Nov 9 18:07:50 PST 2011
renee_berry
@joltdude thanks! Tired :) but happy there's some quiet at the moment :) #hpm
Wed Nov 9 18:08:23 PST 2011
IM4PBS
thanks for the welcome @equijada! have lurked several times in the past. #hpm very important subject!
Wed Nov 9 18:08:42 PST 2011
equijada
t1: Along with caring for those with serious illness, #hpm also tends to caregivers. How is it best to treat caregiver guilt? #hpm
Wed Nov 9 18:10:04 PST 2011
AfternoonNapper
Hi all; sorry I'm a bit late. #hpm

Wed Nov 9 18:10:37 PST 2011
renee_berry
RT @equijada: t1: Along with caring for those with serious illness, #hpm also tends to caregivers. How is it best to treat caregiver gui ...
Wed Nov 9 18:10:40 PST 2011
aliciabloom
MSW, LSW practicing in #hpm. direct patient care, program development & clinical education. the latter is my favorite! #hpm
Wed Nov 9 18:10:50 PST 2011
IM4PBS
RT @equijada: t1: Along with caring for those with serious illness, #hpm also tends to caregivers. How is it best to treat caregiver gui ...
Wed Nov 9 18:10:54 PST 2011
aliciabloom
assessment of caregiver burden & guilt is critical component. identifying the source allows for appropriate intervention. #hpm
Wed Nov 9 18:12:02 PST 2011
renee_berry
T1 Interesting, thinking about treating caregiver guilt for myself is a different thought process than treating it for someone esle #hpm
Wed Nov 9 18:12:16 PST 2011
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AfternoonNapper
Can you define caregiver guilt? #hpm

Wed Nov 9 18:12:20 PST 2011
jordangrumet
T1: caregiver guilt is a sign of helplessness. Empower family and Friends. #hpm
Wed Nov 9 18:12:23 PST 2011
equijada
Had a caregiver visiting spouse with dementia everyday. She is burning out but feels guilty when she doesn't visit. #hpm
Wed Nov 9 18:12:36 PST 2011
authordhallman
Caregiver guilt - not doing enough, being the survivor, etc. Profs listening helps. SM to connect w others... #hpm
Wed Nov 9 18:13:16 PST 2011
renee_berry
T1 I think it's so important for caregivers to know it's not just ok to take time for themselves, it's necessary #hpm
Wed Nov 9 18:13:20 PST 2011
equijada
@aliciabloom how do you identify source of guilt and burden? #hpm

Wed Nov 9 18:13:35 PST 2011
jordangrumet
T1: remind caregivers that they have to tend to themselves as well as their loved ones. #hpm
Wed Nov 9 18:13:42 PST 2011
IM4PBS
T1: I wish I had been able 2draw upon caregiver support groups- f2f or virtually-but I did not have either. We can help each other! #hpm
Wed Nov 9 18:13:45 PST 2011
equijada
@authordhallman yes, I think connecting to the community is important #hpm

Wed Nov 9 18:14:06 PST 2011
aliciabloom
caregiver distress: identify, normalize, reframe, develop intervention. be sure they know without self-care they cannot be a caregiver. #hpm
Wed Nov 9 18:14:17 PST 2011
jordangrumet
RT @IM4PBS: T1: I wish I had been able 2draw upon caregiver support groups- f2f or virtually-but I did not have either. We can help each other! #hpm
Wed Nov 9 18:14:32 PST 2011
kdhoffman2
RT @renee_berry: T1 I think its so important for caregivers to know its not just ok to take time for themselves, its necessary #hpm
Wed Nov 9 18:14:53 PST 2011
equijada
@jordangrumet yes, but what if they won't care for themselves? #hpm
Wed Nov 9 18:14:57 PST 2011
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jordangrumet
T1: we have to honor caregivers contribution. #hpm

Wed Nov 9 18:15:31 PST 2011
equijada
@aliciabloom is there a point where it is appropriate to medically intervene for patient? i.e. recommend anti-depressant etc.. #hpm
Wed Nov 9 18:15:40 PST 2011
aliciabloom
@equijada sometimes simply acknowledging the magnitude of caregiving can offer family the space to express distress, guilt, fears. #hpm
Wed Nov 9 18:15:50 PST 2011
AfternoonNapper
If at all possible, patients need to be active in encouraging their caregivers to be cared for themselves. #hpm
Wed Nov 9 18:15:54 PST 2011
renee_berry
@aliciabloom daaang, spoken like a pro :) #hpm

Wed Nov 9 18:15:55 PST 2011
renee_berry
RT @aliciabloom: caregiver distress: identify, normalize, reframe, develop intervention. be sure they know without self-care they cannot be a caregiver. #hpm
Wed Nov 9 18:15:58 PST 2011
equijada
RT @jordangrumet: T1: we have to honor caregivers contribution. #hpm

Wed Nov 9 18:15:59 PST 2011
IM4PBS
Agree! May need back-up help. RT @renee_berry T1 It's so imp. 4caregivers 2know it's not just ok 2take time 4themselves, its necessary #hpm
Wed Nov 9 18:16:12 PST 2011
renee_berry
RT @AfternoonNapper: If at all possible, patients need to be active in encouraging their caregivers to be cared for themselves. #hpm
Wed Nov 9 18:16:19 PST 2011
jessicajohanna
Hi all! Sorry I'm late. I'll just jump right in to t1. i think it's important that caregivers practice reflection that can ease fatigue #hpm
Wed Nov 9 18:16:22 PST 2011
annwax
@IM4PBS Good evening to everyone, sorry that I am late #hpm

Wed Nov 9 18:16:29 PST 2011
jordangrumet
@equijada we have to meet them where they are. Can't force it. #hpm
Wed Nov 9 18:16:55 PST 2011
equijada
How do you teach self-care when there is too much guilt? #hpm
Wed Nov 9 18:16:57 PST 2011
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authordhallman
I gratefully accepted overnight support until near end, then I wanted to be alone w Bill. Profs objected but agreed to my wish. #hpm
Wed Nov 9 18:16:59 PST 2011
aliciabloom
@equijada interesting. i suppose there are some scenarios where situational distress can lead to depression & need med management. #hpm
Wed Nov 9 18:17:12 PST 2011
equijada
@jessicajohanna welcome jessica, welcome ann #hpm

Wed Nov 9 18:17:14 PST 2011
annwax
@equijada Guilt is a terrible energy, and it takes it toll on caregivers. #hpm

Wed Nov 9 18:17:15 PST 2011
aliciabloom
@renee_berry you're good to me :) #hpm

Wed Nov 9 18:17:21 PST 2011
IM4PBS
People need 2realize how imp. a few hours of relief can b4 cg RT @equijada: @jordangrumet yes, but what if they won't care 4hemselves? #hpm
Wed Nov 9 18:17:59 PST 2011
AfternoonNapper
When in high caregiver need situation, I still try to make arrangements so caregiving is distributed & people get a break from me. #hpm
Wed Nov 9 18:18:04 PST 2011
annwax
@aliciabloom @equijada It is very easy to get depressed when you are a caregiver #hpm
Wed Nov 9 18:18:12 PST 2011
kdhoffman2
when doing 24/7 among 3 other sibs, caregiver guilt over taking time away was huge-couldn't get one sib to rest #hpm
Wed Nov 9 18:18:12 PST 2011
renee_berry
RT @annwax: @aliciabloom @equijada It is very easy to get depressed when you area caregiver #hpm
Wed Nov 9 18:18:38 PST 2011
aliciabloom
guilt can often be the surface emotion. what's underneath it, what's the source? #hpm
Wed Nov 9 18:18:55 PST 2011
equijada
@IM4PBS as a caregiver, who much sleep were you getting on average? #hpm
Wed Nov 9 18:19:07 PST 2011
equijada
RT @aliciabloom: guilt can often be the surface emotion. whats underneath it, whats the source? #hpm
Wed Nov 9 18:19:19 PST 2011
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aliciabloom
RT @annwax: @aliciabloom @equijada It is very easy to get depressed when you area caregiver <-- absolutely. physical AND emotional toll #hpm
Wed Nov 9 18:19:47 PST 2011
annwax
@equijada You teach self care, by explaining to take things in small baby steps, and what you are doing does make a difference. #hpm
Wed Nov 9 18:19:51 PST 2011
equijada
@im4pbs - correction "how much sleep"? #hpm

Wed Nov 9 18:19:57 PST 2011
AfternoonNapper
@aliciabloom Loss and anger and some resentment are partnered with guiltand those are all ok. #hpm
Wed Nov 9 18:20:14 PST 2011
jessicajohanna
Guilt feels inescapable. It's important to identify why you feel guilt and talk about it with others #hpm
Wed Nov 9 18:20:32 PST 2011
kdhoffman2
my older sib...when needed to take action to get a catheter into family member who needed it, she couldn't/wouldn't take that action #hpm
Wed Nov 9 18:20:36 PST 2011
equijada
RT @AfternoonNapper: @aliciabloom Loss and anger and some resentment are partnered with guiltand those are all ok. #hpm
Wed Nov 9 18:20:42 PST 2011
annwax
@aliciabloom @equijada When I speak with care givers I always emphasize what they are doing is very important #hpm
Wed Nov 9 18:20:52 PST 2011
equijada
RT @jessicajohanna: Guilt feels inescapable. Its important to identify why you feel guilt and talk about it with others #hpm
Wed Nov 9 18:21:01 PST 2011
jordangrumet
T1 Caregiver guilt is attempt to control destiny. We can love, we can support, but we can't stop the inevitable. #hpm
Wed Nov 9 18:21:19 PST 2011
aliciabloom
RT @jessicajohanna: Guilt feels inescapable. Its important to identify why you feel guilt and talk about it with others #hpm
Wed Nov 9 18:21:32 PST 2011
jordangrumet
RT @jessicajohanna: Guilt feels inescapable. It's important to identify why you feel guilt and talk about it with others #hpm
Wed Nov 9 18:21:43 PST 2011
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IM4PBS
not enough :-) I never felt rested or renewed RT @equijada: @IM4PBS as a caregiver, who much sleep were you getting on average? #hpm
Wed Nov 9 18:21:51 PST 2011
kdhoffman2
RT @jordangrumet: T1 Caregiver guilt is attempt to control destiny. We can love, we can support, but we cant stop the inevitable. #hpm
Wed Nov 9 18:21:52 PST 2011
equijada
RT @jordangrumet: T1 Caregiver guilt is attempt to control destiny. We can love, we can support, but we cant stop the inevitable. #hpm
Wed Nov 9 18:22:06 PST 2011
annwax
@kdhoffman2 Decisions are very difficult, there is alot of emotional baggage that goes with them #hpm
Wed Nov 9 18:22:28 PST 2011
equijada
RT @IM4PBS: not enough :-) I never felt rested or renewed #hpm

Wed Nov 9 18:22:32 PST 2011
aliciabloom
@annwax i always tell the families i work with how fortunate my patient is to have them as a caregiver, advocate, supporter. #hpm
Wed Nov 9 18:22:32 PST 2011
ShahinaLakhani
A Message To The End Of Life Care Health Professionals #hpm #eolchat Caregivers http://t.co/cBZASz8l
Wed Nov 9 18:22:35 PST 2011
equijada
Here are some mind boggling stats on caregiving http://t.co/H4Ivi7Eo #hpm

Wed Nov 9 18:22:48 PST 2011
renee_berry
T1 I get anxiety that there are things I should be doing but haven't thought of because I'm tired #hpm
Wed Nov 9 18:23:05 PST 2011
IM4PBS
RT @aliciabloom: @equijada sometimes simply acknowledging the magnitude of caregiving can offer family the space to express distress, guilt, fears. #hpm
Wed Nov 9 18:23:55 PST 2011
equijada
t2: autonomy rules in health, when is it appropriate to intervene/disrupt caregiver/pt relationship if both are declining fast #hpm
Wed Nov 9 18:24:00 PST 2011
milhealth
@renee_berry here is one good caretaker assessment from AMA #hpm http://t.co/X59qX1Jf
Wed Nov 9 18:24:05 PST 2011
renee_berry
RT @jessicajohanna: Guilt feels inescapable. It's important to identify why you feel guilt
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and talk about it with others #hpm

Wed Nov 9 18:24:06 PST 2011
jordangrumet
T1 Remind caregivers that the most important thing they do is love...the rest is secondary #hpm
Wed Nov 9 18:24:12 PST 2011
IM4PBS
RT @authordhallman: I gratefully accepted overnight support until near end, then I wanted to be alone w Bill. Profs objected but agreed to my wish. #hpm
Wed Nov 9 18:24:22 PST 2011
equijada
for example, i've seen many 77 yo spouse taking care of 82 yo spouse #hpm
Wed Nov 9 18:24:34 PST 2011
aliciabloom
@equijada i just touched on some of these caregiving stats in a lecture about dementia to highlight the importance of #hospice referral #hpm
Wed Nov 9 18:24:39 PST 2011
annwax
@kdhoffman2 @jordangrumet I try to explain to caregivers, that the person that they are caring for, does have their own thoughts .#hpm
Wed Nov 9 18:24:39 PST 2011
annwax
@equijada That is not an unusual scenario, and we will see more of that #hpm
Wed Nov 9 18:25:24 PST 2011
AfternoonNapper
Patient to caregivers: I'm sorry to put you in this situation. Thank you for being there. I'm sorry I'm mean sometimes. I love you. #hpm
Wed Nov 9 18:25:32 PST 2011
equijada
@jordangrumet yes, but what if basic needs are being neglected? do we intervene or let things just go... #hpm
Wed Nov 9 18:25:35 PST 2011
renee_berry
RT @milhealth: @renee_berry here is one good caretaker assessment from AMA #hpm http://t.co/X59qX1Jf
Wed Nov 9 18:25:38 PST 2011
ManonC1sports
RT @kdhoffman2: RT @jordangrumet: T1 Caregiver guilt is attempt to control destiny. We can love, we can support, but we cant stop the inevitable. #hpm
Wed Nov 9 18:25:53 PST 2011
colekpharm
MY @annwax: @equijada You teach self care, by explaining to take things in small steps, and what you are doing does make a difference. #hpm
Wed Nov 9 18:26:00 PST 2011
equijada
@aliciabloom yes, we get many hospice referrals for this, but often times family needs more than a nursing visit. #hpm
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Wed Nov 9 18:26:08 PST 2011
renee_berry
RT @colekpharm: MY @annwax: @equijada You teach self care, by explaining to take things in small steps, and what you are doing does make a difference. #hpm
Wed Nov 9 18:26:52 PST 2011
annwax
@aliciabloom @equijada I also explain to pt's when they are going on hospice, that passing can be a very gentle way. #hpm
Wed Nov 9 18:27:02 PST 2011
jordangrumet
t2 goal of hospice to die with dignity. Must intervene if caregiver relationship getting in the way of this. #hpm
Wed Nov 9 18:27:31 PST 2011
KatieBe_NC
RT @renee_berry: T1 I think it's so important for caregivers to know it's not just ok to take time for themselves, it's necessary #hpm
Wed Nov 9 18:27:36 PST 2011
kdhoffman2
the catheterization happened after family member had mets to the brain; couldn't tell us when she needed bedpan; a day or so be4 end #hpm
Wed Nov 9 18:27:41 PST 2011
annwax
@equijada @aliciabloom I also find that the word hospice still make ppl get the chills #hpm
Wed Nov 9 18:27:58 PST 2011
equijada
Often times when pts come to hospice, they need the extra layer of support for caregiving but don't want to discuss the dying part #hpm
Wed Nov 9 18:28:10 PST 2011
authordhallman
T2 We could have Bill at home w pallcare b/c I was strong enough to coordinate care. More difficult 4 fragile caregivers. #hpm
Wed Nov 9 18:28:13 PST 2011
aliciabloom
autonomy is important, but cannot be realized without true understanding & informed consent. education & honest goal-setting discussion #hpm
Wed Nov 9 18:28:24 PST 2011
jordangrumet
Intervene@equijada: @jordangrumet yes, but what if basic needs are being neglected? do we intervene or let things just go... #hpm"
Wed Nov 9 18:28:31 PST 2011
annwax
@kdhoffman2 It is unfortunate about that situation #hpm

Wed Nov 9 18:28:50 PST 2011
equijada
@jordangrumet yes, but caregiver doesn't want placement. still want to care at home...even though it's not working out. #hpm
Wed Nov 9 18:29:03 PST 2011
http://hashtags.symplur.com/healthcare-hashtag-transcript.php?h&smin=0&tdate=11-09-2011&thour=19&tmin=15&ssec=00&tsec=00&img=1
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aliciabloom
the word hospice is still scary, like dropping a bomb. good end of life discussions do not start with the h word, but focus on values. #hpm
Wed Nov 9 18:29:17 PST 2011
renee_berry
listening to an admissions person explain an advance directive right now, the conversation can be explained in a tweet... #hpm
Wed Nov 9 18:29:20 PST 2011
renee_berry
who will make your decisions, your wife? ok sign here. we're done. #hpm
Wed Nov 9 18:29:40 PST 2011
IM4PBS
CGs need that affirmation! MT @AfternoonNapper: @aliciabloom Loss, anger & some resentment are partnered with guilt those are all ok. #hpm
Wed Nov 9 18:29:41 PST 2011
joltdude
Not doing a good job, huh @renee_berry #hpm

Wed Nov 9 18:29:59 PST 2011
aliciabloom
@renee_berry do you have an advance directive? do you want information on one? (boxes on form are checked) #hpm
Wed Nov 9 18:29:59 PST 2011
IM4PBS
Extremely imp. RT @jessicajohanna: Guilt feels inescapable. It's important to identify why you feel guilt and talk about it with others #hpm
Wed Nov 9 18:30:08 PST 2011
renee_berry
(sorry off topic #squirming) #hpm

Wed Nov 9 18:30:09 PST 2011
AnitaMedia
Difficult but important discussion @renee_berry: Tweeting by a hospital bed tonight how important advance directives are #hpm
Wed Nov 9 18:30:17 PST 2011
aliciabloom
@renee_berry admissions person probably not the right person to have the advance directive discussion (?) #hpm
Wed Nov 9 18:30:21 PST 2011
IM4PBS
RT @annwax: @aliciabloom @equijada When I speak with care givers I always emphasize what they are doing is very important #hpm
Wed Nov 9 18:30:27 PST 2011
equijada
@im4pbs - what was the most helpful thing for you as a caregiver? #hpm
Wed Nov 9 18:30:47 PST 2011
IM4PBS
RT @jordangrumet: T1 Caregiver guilt is attempt to control destiny. We can love, we can support, but we can't stop the inevitable. #hpm
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Wed Nov 9 18:30:55 PST 2011
renee_berry
@aliciabloom right?! #hpm

Wed Nov 9 18:31:03 PST 2011
annwax
@jordangrumet When I explain to the caregivers, that they will have more quality time with a pt. if they use hospice #hpm they feel better
Wed Nov 9 18:31:12 PST 2011
renee_berry
RT @equijada: @im4pbs - what was the most helpful thing for you as a caregiver? #hpm
Wed Nov 9 18:31:13 PST 2011
equijada
@IM4PBS yes, so very important #hpm

Wed Nov 9 18:31:20 PST 2011
kdhoffman2
oncologist didn't bring hospice in...we all just kept taking care of her in the hospital..24/7 #hpm
Wed Nov 9 18:31:34 PST 2011
IM4PBS
RT @ShahinaLakhani: A Message To The End Of Life Care Health Professionals #hpm #eolchat Caregivers http://t.co/cBZASz8l
Wed Nov 9 18:31:36 PST 2011
aliciabloom
MT @equijada: Often when pts come to hospice, need extra support for caregiving, don't want to discuss dying part <- it's a process #hpm
Wed Nov 9 18:31:38 PST 2011
IM4PBS
RT @ShahinaLakhani: A Message To The End Of Life Care Health Professionals #hpm #eolchat Caregivers http://t.co/Ry0CauLx
Wed Nov 9 18:31:40 PST 2011
IM4PBS
RT @equijada: Here are some mind boggling stats on caregiving http://t.co/H4Ivi7Eo #hpm
Wed Nov 9 18:31:40 PST 2011
jordangrumet
RT @annwax: @jordangrumet When I explain to the caregivers, that they will have more quality time with a pt. if they use hospice #hpm th ...
Wed Nov 9 18:31:42 PST 2011
IM4PBS
RT @equijada: Here are some mind boggling stats on caregiving http://t.co/R2B66RWY #hpm
Wed Nov 9 18:31:45 PST 2011
IM4PBS
RT @equijada: t2: autonomy rules in health, when is it appropriate to intervene/disrupt caregiver/pt relationship if both are declining fast #hpm
Wed Nov 9 18:31:53 PST 2011
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IM4PBS
RT @milhealth: @renee_berry here is one good caretaker assessment from AMA #hpm http://t.co/X59qX1Jf
Wed Nov 9 18:32:06 PST 2011
IM4PBS
RT @milhealth: @renee_berry here is one good caretaker assessment from AMA #hpm http://t.co/BvyK38fT
Wed Nov 9 18:32:09 PST 2011
equijada
t2: we are privy to information when going into a home. What do you do with the inappropriate person at home who isn't the caregiver? #hpm
Wed Nov 9 18:32:27 PST 2011
rlbates
RT @jordangrumet T1 Caregiver guilt is attempt to control destiny. We can love, we can support, but we can't stop the inevitable. #hpm
Wed Nov 9 18:33:31 PST 2011
equijada
t2 explanation: i.e. the son who might be breaking parole, drugs in the home, sexual harrassment etc... #hpm
Wed Nov 9 18:33:38 PST 2011
equijada
t2: as a professional in the home, when does justice trump autonomy? #hpm
Wed Nov 9 18:34:11 PST 2011
IM4PBS
My grandmother took care of my grandfather w Alzheimers until he was no longer ambulatory/responsive. Convinced her time4 nursing home #hpm
Wed Nov 9 18:34:22 PST 2011
AfternoonNapper
@equijada Do hospice type workers not have the right to call law enforcement officers? #hpm
Wed Nov 9 18:34:41 PST 2011
SheyontheBay
MT@aliciabloom: the word hospice is still scary, good end of life discussions do not start with the h word, but focus on values. < YES! #hpm
Wed Nov 9 18:34:41 PST 2011
IM4PBS
RT @AfternoonNapper: Patient to caregivers: I'm sorry to put you in this situation. Thank you for being there. I'm sorry I'm mean sometimes. I love you. #hpm
Wed Nov 9 18:34:48 PST 2011
aliciabloom
honest discussion with patient or their health care proxy about caregiver concerns is a good place to start. #hpm
Wed Nov 9 18:35:04 PST 2011
IM4PBS
RT @jordangrumet: t2 goal of hospice to die with dignity. Must intervene if caregiver relationship getting in the way of this. #hpm
Wed Nov 9 18:35:28 PST 2011
jordangrumet
t2: there are times when being the professional means trumping autonomy but only
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extreme situations. #hpm

Wed Nov 9 18:35:44 PST 2011
equijada
@AfternoonNapper yes they do, where is that line though when you are a visitor to the home providing care for someone else #hpm
Wed Nov 9 18:35:45 PST 2011
SheyontheBay
RT @AfternoonNapper Do hospice type workers not have the right to call law enforcement officers?< Of course, usually by SW member #hpm
Wed Nov 9 18:36:29 PST 2011
AfternoonNapper
@equijada If a visiting caregiver sees anything criminal (abuse, drugs, etc), I think they are duty bound to notify law enforcement. #hpm
Wed Nov 9 18:36:37 PST 2011
equijada
@aliciabloom along with caregiver guilt, i've seen a lot of caregiver fear. #hpm
Wed Nov 9 18:36:42 PST 2011
IM4PBS
true! MT @authordhallman: T2 Bill could b at home w pallcare b/c I was strong enough 2coordinate care. +difficult 4fragile caregivers. #hpm
Wed Nov 9 18:37:11 PST 2011
renee_berry
interesting RT @equijada: t2: as a professional in the home, when does justice trump autonomy? #hpm
Wed Nov 9 18:37:12 PST 2011
SheyontheBay
RT @jordangrumet: t2: there are times when being the professional means trumping autonomy but only extreme situations. #hpm
Wed Nov 9 18:37:18 PST 2011
aliciabloom
remember, we're coming to the theater during act 3. we can't change nor fully understand first 2 acts & act 4 will continue without us. #hpm
Wed Nov 9 18:37:25 PST 2011
equijada
where do you draw the line to call? - screaming family members? MJ in the home, inappropriate advances to nurses? #hpm
Wed Nov 9 18:37:39 PST 2011
equijada
RT @aliciabloom: remember, we're coming to the theater during act 3. we can't change nor fully understand first 2 acts & act 4 will continue without us. #hpm
Wed Nov 9 18:38:01 PST 2011
jessicajohanna
Wed Nov 9 18:38:28 PST 2011
jessicajohanna
@aliciabloom well put! #hpm

Wed Nov 9 18:38:39 PST 2011
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6/27/12 12:38 PM
equijada
Just saying...these are front line realities of act 3. totally agree #hpm
Wed Nov 9 18:39:15 PST 2011
jordangrumet
@equijada experience allows us to step in in harmful situations and intervene.Sometimes patients need you to make decisions withfor them#hpm
Wed Nov 9 18:39:21 PST 2011
IM4PBS
agree! RT @aliciabloom: the word hospice is still scary, like dropping a bomb. good #eol discussions focus on values 1st, not hospice. #hpm
Wed Nov 9 18:39:27 PST 2011
SheyontheBay
@equijada If concern for safety of anyone in the home exists, family or visitor, must make apprpriate call #hpm
Wed Nov 9 18:39:30 PST 2011
equijada
RT @SheyontheBay: @equijada If concern for safety of anyone in the home exists, family or visitor, must make apprpriate call #hpm
Wed Nov 9 18:40:04 PST 2011
aliciabloom
@equijada the front line realities are there. don't mean to diminish it. when safety is truly compromised (weapons, signs of abuse). #hpm
Wed Nov 9 18:40:22 PST 2011
equijada
@SheyontheBay I totally agree, I regret when I make the call too late. #hpm
Wed Nov 9 18:40:46 PST 2011
jordangrumet
@equijada great questions! #hpm

Wed Nov 9 18:40:52 PST 2011
AfternoonNapper
Patient safety and caregiver safety is of utmost importance. Without both the care is unsuccessful. #hpm
Wed Nov 9 18:41:00 PST 2011
jordangrumet
RT @AfternoonNapper: Patient safety and caregiver safety is of utmost importance. Without both the care is unsuccessful. #hpm
Wed Nov 9 18:41:21 PST 2011
IM4PBS
Hospice! Provided all family members w needed support! RT @equijada: @im4pbs - what was the most helpful thing for you as a caregiver? #hpm
Wed Nov 9 18:41:34 PST 2011
aliciabloom
@equijada @Sheyonthebay it's such a tough call and a fine line. #hpm
Wed Nov 9 18:41:37 PST 2011
SheyontheBay
RT @equijada: @SheyontheBay I totally agree, I regret when I make the call too late.<- :( #hpm
Page 15 of 20
6/27/12 12:38 PM
Wed Nov 9 18:41:52 PST 2011
equijada
it's always awkward, because we are coming into act 3. what we're seeing might be normal for the patient. Part of their narrative. #hpm
Wed Nov 9 18:42:21 PST 2011
jordangrumet
Goal of care :Patient dignity>caregiver dignity>healthcare worker dignity #hpm

Wed Nov 9 18:42:47 PST 2011
IM4PBS
I felt gr8 relief! MT @annwax: When I explain 2caregivers they will have +quality time w/ a pt. if they use hospice #hpm they feel better
Wed Nov 9 18:42:56 PST 2011
equijada
Though are goals are dignity, maybe are goals should be to be with them through act 4 #hpm
Wed Nov 9 18:43:00 PST 2011
aliciabloom
+1 agree! MT @equijada: always awkward, because we are coming into act 3. what were seeing might be normal. part of their narrative. #hpm
Wed Nov 9 18:43:13 PST 2011
SheyontheBay
@equijada That's one reason I so appreciate interdisciplinary team! #hpm

Wed Nov 9 18:43:20 PST 2011
equijada
Ok, t3 coming up and let's LIGHTEN THIS THING UP! haha #hpm
Wed Nov 9 18:43:39 PST 2011
ManonC1sports
RT @AfternoonNapper: Patient safety and caregiver safety is of utmost importance. Without both the care is unsuccessful. #hpm
Wed Nov 9 18:43:40 PST 2011
aliciabloom
RT @jordangrumet: Goal of care: patient dignity > caregiver dignity > healthcare worker dignity #hpm
Wed Nov 9 18:43:55 PST 2011
equijada
t3: give me beautiful caregiver stories. There are lots of them #hpm
Wed Nov 9 18:44:07 PST 2011
IM4PBS
RT @aliciabloom: honest discussion with patient or their health care proxy about caregiver concerns is a good place to start. #hpm
Wed Nov 9 18:44:14 PST 2011
AfternoonNapper
@equijada @aliciabloom No matter if it is part of the narrative, abuse is unacceptable. #hpm

Wed Nov 9 18:44:25 PST 2011
Page 16 of 20
6/27/12 12:38 PM
aliciabloom
wife of 63 years at the bedside of her husband who is non-responsive s/p CVA holding his hand, telling the story of how they met. #hpm
Wed Nov 9 18:45:49 PST 2011
IM4PBS
RT @equijada: t3: give me beautiful caregiver stories. There are lots of them #hpm
Wed Nov 9 18:46:15 PST 2011
authordhallman
T3 Readers tell me August Farewell is part pall/care & part love story. Not for me to say. #hpm
Wed Nov 9 18:46:18 PST 2011
SheyontheBay
t3 I witnessed a nurse with the most angelic voice singing to an actively dying pt- felt like I saw the notes lift her to heaven! #hpm
Wed Nov 9 18:46:29 PST 2011
equijada
Here is a caregiver I'll never forget http://t.co/y3hnniYg #hpm

Wed Nov 9 18:46:30 PST 2011
jordangrumet
t3: for caregiver stories follow my blog. Are many of them there. http://t.co/0M7eq8ie. #hpm
Wed Nov 9 18:46:34 PST 2011
IM4PBS
RT @SheyontheBay: t3 I witnessed a nurse with the most angelic voice singing to an actively dying pt- felt like I saw the notes lift her to heaven! #hpm
Wed Nov 9 18:46:56 PST 2011
jordangrumet
RT @SheyontheBay: t3 I witnessed a nurse with the most angelic voice singing to an actively dying pt- felt like I saw the notes lift her to heaven! #hpm
Wed Nov 9 18:47:05 PST 2011
IM4PBS
RT @authordhallman: T3 Readers tell me August Farewell is part pall/care & part love story. Not for me to say. #hpm
Wed Nov 9 18:47:08 PST 2011
IM4PBS
RT @aliciabloom: wife of 63 years at the bedside of her husband who is non-responsive s/p CVA holding his hand, telling the story of how they met. #hpm
Wed Nov 9 18:47:13 PST 2011
IM4PBS
RT @equijada: Here is a caregiver I'll never forget http://t.co/W4o9ntRs #hpm

Wed Nov 9 18:47:22 PST 2011
aliciabloom
@jordangrumet your link isn't working :( #hpm

Wed Nov 9 18:47:24 PST 2011
_lizzy_
Wed Nov 9 18:47:26 PST 2011
Page 17 of 20
6/27/12 12:38 PM
IM4PBS
RT @jordangrumet: t3: for caregiver stories follow my blog. Are many of them there. http://t.co/0M7eq8ie. #hpm
Wed Nov 9 18:47:30 PST 2011
IM4PBS
RT @jordangrumet: t3: for caregiver stories follow my blog. Are many of them there. http://t.co/iSDNR5cu #hpm
Wed Nov 9 18:47:35 PST 2011
AfternoonNapper
This is a caregiver story/love story about what happens when a new marriage is hit by a sudden health event. http://t.co/y1AND4qY #hpm
Wed Nov 9 18:48:04 PST 2011
jessicajohanna
That's incredible RT @equijada: Here is a caregiver Ill never forget http://t.co/t9NnNtGe #hpm
Wed Nov 9 18:48:17 PST 2011
equijada
@jessicajohanna I've had so many caregivers teach me about Love. With the capital L #hpm
Wed Nov 9 18:49:03 PST 2011
renee_berry
RT @equijada: @jessicajohanna Ive had so many caregivers teach me about Love. With the capital L #hpm
Wed Nov 9 18:49:22 PST 2011
_lizzy_
Planning a "Make It Happen" bowling outing for #hospice patient. Love volunteering. #hpm
Wed Nov 9 18:49:50 PST 2011
aliciabloom
RT @equijada: @jessicajohanna Ive had so many caregivers teach me about Love. With the capital L. <- one of many gifts of our work. #hpm
Wed Nov 9 18:50:03 PST 2011
renee_berry
awesome RT @_lizzy_: Planning a "Make It Happen" bowling outing for #hospice patient. Love volunteering #hpm
Wed Nov 9 18:50:23 PST 2011
IM4PBS
Those moments help renew you! RT @equijada: @jessicajohanna Ive had so many caregivers teach me about Love. With the capital L #hpm
Wed Nov 9 18:50:34 PST 2011
equijada
Thanks for chatting everyone. Heading off a little early! #hpm

Wed Nov 9 18:50:35 PST 2011
equijada
thanks for your stories. final thoughts about caregiving? #hpm

Wed Nov 9 18:50:53 PST 2011
SheyontheBay
@equijada Yikes, Earl! I'll never forget that one, either! #hpm
Wed Nov 9 18:51:11 PST 2011
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6/27/12 12:38 PM
IM4PBS
RT @equijada: thanks for your stories. final thoughts about caregiving? #hpm
Wed Nov 9 18:51:17 PST 2011
renee_berry
Thanks for chatting tonight! RT @equijada: Thanks for chatting everyone. Heading off a little early! #hpm
Wed Nov 9 18:51:19 PST 2011
jordangrumet
@aliciabloom I think it works now #hpm

Wed Nov 9 18:51:34 PST 2011
aliciabloom
@equijada thanks for hosting! enjoyed the caregiver focus of tonight's #hpm tweetchat #hpm
Wed Nov 9 18:51:37 PST 2011
joltdude
Final thought about caregiving.. Listen to the one being cared for and let them steer whats going on when they can #hpm
Wed Nov 9 18:51:38 PST 2011
equijada
@renee_berry thanks for caregiving for your family tonight! #hpm

Wed Nov 9 18:51:55 PST 2011
AfternoonNapper
Thank you to all for sharing. Thank you for caring. Really. #hpm
Wed Nov 9 18:52:11 PST 2011
renee_berry
RT @aliciabloom: @equijada thanks for hosting! enjoyed the caregiver focus of tonight's #hpm tweetchat #hpm
Wed Nov 9 18:52:14 PST 2011
IM4PBS
#eol and #hpm discussions held and decisions made in healthy times makes caregiving in trying terminal times easier.
Wed Nov 9 18:53:09 PST 2011
authordhallman
Thanks friends for another good hpm tweetchat #hpm

Wed Nov 9 18:53:10 PST 2011
jordangrumet
Great chat.#hpm
Wed Nov 9 18:53:11 PST 2011
equijada
@AfternoonNapper thanks! #hpm

Wed Nov 9 18:53:20 PST 2011
IM4PBS
RT @joltdude: Final thought about caregiving.. Listen to the one being cared for and let them steer whats going on when they can #hpm
Wed Nov 9 18:53:37 PST 2011
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6/27/12 12:38 PM
IM4PBS
:-) RT @AfternoonNapper: Thank you to all for sharing. Thank you for caring. Really. #hpm
Wed Nov 9 18:53:56 PST 2011
aliciabloom
RT @equijada: @renee_berry thanks for caregiving for your family tonight! <- co-signing this tweet & sending good thoughts your way! #hpm
Wed Nov 9 18:57:53 PST 2011
ctsinclair
The #hpm Daily is out! http://t.co/hXekg5Al Top stories today via @hospicevalley @hospicepharmacy @aliciabloom @haslingerppc
Wed Nov 9 19:00:36 PST 2011
aliciabloom
RT @ctsinclair: The #hpm Daily is out! http://t.co/hXekg5Al Top stories today via @hospicevalley @hospicepharmacy @aliciabloom @haslin ...
Wed Nov 9 19:03:53 PST 2011
_lizzy_
@equijada i stumbled upon the #hpm chat by accident and didnt realize the format. i am so excited.. when is the next one?
Wed Nov 9 19:04:11 PST 2011
joltdude
@_lizzy_ Forget the exact time but #HPM is roughly every wednesday an hour before #eolchat
Wed Nov 9 19:06:47 PST 2011
DrBeckerSchutte
@_lizzy_ The #EOLchat is Wednesdays at 9 pm CST. #hpm chat is Wednesdays at 8 pm CST. #EOLchat
Wed Nov 9 19:08:45 PST 2011
joltdude
@DrBeckerSchutte Thanks. Im bad with times. also directed her to Fox's medical hashtag and tweetchat list http://t.co/ox2pnBP6 #hpm #eolchat
Wed Nov 9 19:09:29 PST 2011
Page 20 of 20

#HPM Tweet Chat 11:9:11

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#HPM Tweet Chat 11:9:11

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#hpm - Healthcare Social Media Transcript

For the next hour, I will chatting about #hpm. #hpm

@equijada Hi Earl, thanks for hosting tonight! #hpm

Wifes out of town, kids asleep, ready for tweetchat #hpm

Hi Renee, Alicia, and Jordan, good to see you #hpm

#hpm - Healthcare Social Media Transcript

end of life care in Oregon: http://t.co/uzwksqF3 #eolc #hpm #eol

@renee_berry off topic: are you going to @rockhealth http://t.co/GVgv6lKT #hpm

Hi David, welcome. August Farewell - sounds interesting #hpm

@renee_berry sorry to hear that...sending good thoughts your way. #hpm

@renee_berry whoa...are you hospitalized? or a friend? or a caregiver? #hpm

topic 1 coming up in a bit. #hpm

topic 1 coming up in a bit. #hpm

#hpm - Healthcare Social Media Transcript

Welcome Deb, thanks for being here. #hpm

@equijada looks awesome, love @rock_health #hpm

Jordan Grumet here...#hpm friendly Internal Med physician

Hi all; sorry I'm a bit late. #hpm

#hpm - Healthcare Social Media Transcript

Can you define caregiver guilt? #hpm

@aliciabloom how do you identify source of guilt and burden? #hpm

@authordhallman yes, I think connecting to the community is important #hpm

#hpm - Healthcare Social Media Transcript

T1: we have to honor caregivers contribution. #hpm

@aliciabloom daaang, spoken like a pro :) #hpm

RT @jordangrumet: T1: we have to honor caregivers contribution. #hpm

@IM4PBS Good evening to everyone, sorry that I am late #hpm

#hpm - Healthcare Social Media Transcript

@jessicajohanna welcome jessica, welcome ann #hpm

@equijada Guilt is a terrible energy, and it takes it toll on caregivers. #hpm

@renee_berry you're good to me :) #hpm

#hpm - Healthcare Social Media Transcript

@im4pbs - correction "how much sleep"? #hpm

#hpm - Healthcare Social Media Transcript

RT @IM4PBS: not enough :-) I never felt rested or renewed #hpm

Here are some mind boggling stats on caregiving http://t.co/H4Ivi7Eo #hpm

#hpm - Healthcare Social Media Transcript

and talk about it with others #hpm

#hpm - Healthcare Social Media Transcript

Wed Nov 9 18:26:08 PST 2011

@kdhoffman2 It is unfortunate about that situation #hpm

#hpm - Healthcare Social Media Transcript

Not doing a good job, huh @renee_berry #hpm

(sorry off topic #squirming) #hpm

#hpm - Healthcare Social Media Transcript

Wed Nov 9 18:30:55 PST 2011

@aliciabloom right?! #hpm

@IM4PBS yes, so very important #hpm

#hpm - Healthcare Social Media Transcript

#hpm - Healthcare Social Media Transcript

extreme situations. #hpm

@aliciabloom well put! #hpm

#hpm - Healthcare Social Media Transcript

@equijada great questions! #hpm

#hpm - Healthcare Social Media Transcript

Wed Nov 9 18:41:52 PST 2011

Goal of care :Patient dignity>caregiver dignity>healthcare worker dignity #hpm

@equijada That's one reason I so appreciate interdisciplinary team! #hpm

@equijada @aliciabloom No matter if it is part of the narrative, abuse is unacceptable. #hpm

#hpm - Healthcare Social Media Transcript

Here is a caregiver I'll never forget http://t.co/y3hnniYg #hpm

RT @equijada: Here is a caregiver I'll never forget http://t.co/W4o9ntRs #hpm

@jordangrumet your link isn't working :( #hpm